AB0275 SERUM LEVELS OF HOMOCYSTEINE, LEPTIN AND NEOPTERIN AS MARKERS OF DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS
Authors: M. Gamal, Y. Gazar, M. Ghait
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic, systemic disorder characterized by the presence of many proinflammatory cytokines that have been involved in the pathogenesis, comorbidity, and premature mortality, due to increased atherosclerotic heart disease[1]. homocysteinemia is an independent risk factor for coronary heart disease, stroke, and an independent predictor for cardiovascular mortality in atherosclerotic patients.[2] leptin is a component of cytokines that mediates immune response and plays an important role in the T-cell related inflammatory process.[3] Neopterin is a pteridine derivative produced by monocytes and macrophages primarily as a response to interferon-gamma stimulation induced by the activation of the cellular immune system.(4) <h3>Objectives</h3> To investig the relationship between serum levels of homocysteine, leptin and neopterin and clinical &amp; laboratory parameters of disease activity in patientes with rheumatoid arthritis. <h3>Methods</h3> This study included 80 RA patients and age&amp; sex-matched 80 healthy controls. RA patients were divided into two groups (A&amp;B) depending on the presence or absence of Extra-articular manifestations. There was 40 with Extra-articular manifestations (9 patients with Cutaneous vasculitis, 7 with Nodules, 6 with Neuropathy, 5 with Reynaud's phenomenon,7 with secondary sjogren, 2 with Fealty's syndrome, 2 with Interstitial nephritis, 2 with Interstitial lung disease). <h3>Results</h3> In the RA group (A+B), mean serum homocysteine, leptin and neopterin levels were (11.79 + 8.72 μmol/L), (22.43 ± 7.37 ng/ml) &amp; (3.83±1.84 nmol/L) respectively with No statistically significant difference was found between RA and control groups regarding serum Leptin (p=0.674). While a significant difference was found between RA and control groups regarding serum Neopetrin (&lt; 0.001) &amp; homocysteine. (&lt; 0.001). Also, In RA groups (A, B) there was a statistically significant difference regarding serum Neopterin (p&lt; 0.03) and DAS 28 ESR (p&lt; 0.05). there was a Positive significant correlation between serum (neopterin - Hcy) and ESR, TNF-α, IL-6, and DAS-28 (p &lt; 0.05) while no significant correlation was found between serum (neopterin- homocysteine) and CRP (p &gt; 0.05). <h3>Conclusion</h3> Serum leptin cannot be considered of value as an marker of disease activity in RA patients. Serum neopterin can be used as a sensitive marker for assaying inflammation and disease activity in RA patients while serum homocysteine can be used as a predictor of RA extra articular complications. <h3>References</h3> [1] Willers J, Hahn A. (2012): Cardiovascular risk in patients with rheumatoid arthritis: assessment of several traditional risk parameters and a German risk score model. Rheumatol Int.; 32:3741-9. [2] Colak A, Avci R, Yener S, et al., (2013): Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women. J Clin Exp Invest.4:293-7. [3] Allam A, Radwan A. (2012): The relationship of serum leptin levels with disease activity in Egyptian patients with rheumatoid arthritis. The Egyptian Rheumatologist;34: 185-90. [4] Hoffmann G, Wirleitner B, Fuchs D. (2003): Potential role of immune system activation-associated production of neopterin derivatives in humans. Inflamm Res; 52:313-21. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.